Individual
CARA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 W BELMONT AVE # 400B, CHICAGO, IL 60657-3200
(618) 207-5873
Mailing address
5424 S ELLIS AVE APT A, CHICAGO, IL 60615-5077
(773) 852-7943
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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